tax-free savings account (tfsa) application - CI Investments

Sun Life Assurance Company of Canada
Tax-Free Savings Account Application Form - January 2012
SunWise Essential Series is an individual variable annuity contract issued
by Sun Life Assurance Company of Canada, a member of the Sun Life
Financial group of companies.
managed by CI Investments Inc.
issued by Sun Life Assurance Company of Canada

What you understand and agree to when you sign this Application.
Your signature in the Planholder Acknowledgement/Authorization section of
this Application confirms you understand the following:
Beneficiary Designation
• the beneficiary designation is revocable, unless the Planholder
designates the beneficiary as irrevocable
• for Contracts signed in Quebec, the relationship stated on the Application
form must be the relationship between the beneficiary and the Planholder
and the designation of a spouse (married or civil union) as beneficiary is
irrevocable unless the Planholder indicates revocable in the Beneficiary
Designation section of the Application
• the person(s) is (are) appointed as the beneficiary(ies) of the Contract in
the event of the death of the Annuitant, if living at the date of that death
• if the beneficiary(ies) predecease(s) the Annuitant, a contingent
beneficiary for that beneficiary’s share, if still alive at the death of the
Annuitant, shall receive that beneficiary’s share of the death benefit. If no
contingent beneficiary for that share is named or is alive at that time, that
share shall be payable to the estate of the deceased Planholder
• in all provinces other than Quebec, if you designate minor children as
beneficiaries, you should also name a trustee to receive funds on their behalf
• in Quebec, if you wish to designate minor children as beneficiaries, any
amount payable to a minor beneficiary during his/her minority will be paid
to the parent(s) or legal guardian of the minor child. A trustee may, also
be designated but a trust must then be set up more formally in accordance
with the Civil Code of Quebec. A lawyer or notary should then be
consulted. Unless specifics of a trust are provided, an appointment of a
trustee/guardian herein shall refer to a guardian according to the Civil
Code of Quebec
• if you name an irrevocable beneficiary you will limit certain rights
you have to deal with the Contract unless you obtain their
signature at the time of the request. A parent or guardian or tutor
cannot provide consent on behalf of a minor who has been named
as irrevocable beneficiary
Guaranteed Lifetime Withdrawal Benefit (GLWB)
• deposits into the Income Class will be accepted until December 31 of the
year the Annuitant turns 80. If the Two-Life Income Stream is designated,
deposits may be accepted until December 31 of the calendar year in which
the youngest of the Annuitant and the Second Life turns 80 years of age
• Lifetime Withdrawal Amount (LWA) payments of 5% for One-Life Income
Stream and 4.5% for Two-Life Income Stream may begin as early as
January 1 of the year the Annuitant (or, if a Second Life is designated, the
younger of the Annuitant and the Second Life) turns 65 years of age
• if the Age 55 LWA Election is made, payments of 4% for One-Life Income
Stream or 3.5% for Two-Life Income Stream may begin as early as
January 1 of the year the Annuitant (or, if a Second Life is designated, the
younger of the Annuitant and the Second Life) turns 55 years of age. In
order to make the Age 55 LWA Election, the SunWise Essential Series
Withdrawal Order Ticket must be submitted along with the SunWise
Essential Series TFSA Application Form
LWA Income Streams:
• an LWA Income Stream, either the One-Life Income Stream or the Two-
Life Income Stream, must be elected at the time of the first deposit into
the Income Class and may not be changed
One-Life Income Stream
• the LWA will be determined based on the age of the Annuitant
• a spouse, named as the sole primary beneficiary, may elect to continue
the TFSA Contract as Successor Planholder and to continue receiving LWA
payments with the Lifetime Income recalculated based on the current
market value
Two-Life Income Stream
• the LWA will be determined based on the age of the younger of the
Annuitant and the Second Life
• only the spouse, as defined in the Income Tax Act, of the Annuitant may
be named as a Second Life
• the Two-Life Income Stream may only be elected when the spouse of the
Annuitant is named as the sole primary beneficiary. The spouse must
continue the TFSA Contract as Successor Planholder
LWA Protection Service
• the LWA Protection Service will be placed on the Income Class to ensure
you do not withdraw amounts in excess of your LWA, unless otherwise
confirmed. This service can be changed, removed or added by you or by
your representative at any time, based on your instructions
Investment Directions
• the fund code selected will determine the guarantee class and
sales charge option of the units invested
• a monthly minimum of $50 per fund is required for pre-authorized chequing
plans (PACs)
• to invest in the Income Class of a TFSA a minimum initial deposit of
$25,000 is required. We will establish the TFSA if the value, in
combination with other Contracts of which you are the Owner and
invested in the Income Class, meets the $25,000 Income Class minimum
• deposits and transfers into a TFSA must be from an account that belongs
to the Planholder
Partial Transfer from another CI account.
• if you have indicated in section 7b that investments are coming from
another CI Contract you authorize CI to withdraw the investments that you
have indicated in this Section
• a transfer from another product may result in a loss of benefits such as
guarantees
• a transfer from another product or plan may result in a taxable disposition
Pre-Authorized Chequing Plans (PAC) Terms and Conditions
• by signing this Application, you hereby waive any pre-notification
requirements as specified by section 15(a) and (b) of the Canadian
Payments Association Rule H1 with regards to PACs
• if you have indicated on the Application that you want to make regular
deposits using a PAC, you authorize CI Investments Inc. (CI), on behalf of
Sun Life, to debit the bank account provided for the specified amount(s)
and in the frequencies selected
• if this is for your own personal investment, your debit will be considered
a Personal Pre-authorized debit agreement (PAD) by Canadian Payments
Association definition. If this is for business purposes, it will be
considered a Business PAD. Monies transferred between CPA members
will be considered a Funds Transfer PAD
• you have certain recourse rights if any debit does not comply with this
agreement. For example, you have the right to receive reimbursement for
any debit that is not authorized or is not consistent with this PAC
agreement. To obtain more information on your recourse rights, you may
contact your financial institution, CI or visit www.cdnpay.ca
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• you may change these instructions or cancel this plan at any time, subject
to providing CI notice of at least 48 hours prior to the next PAC run date.
To obtain a sample cancellation form, or for more information on your right
to cancel a PAC agreement, you may contact your financial institution, CI
or visit the Canadian Payments Association website at www.cdnpay.ca.
You agree to release the financial institution and CI of all liability if the
revocation is not respected, except in the case of gross negligence by the
financial institution or CI
• CI is authorized to accept changes to this agreement from your registered
dealer or your financial advisor in accordance with the policies of that
company, in accordance with the disclosure and authorization
requirements of the CPA
• you agree that the information in this form will be shared with the
financial institution, insofar as the disclosure of this information is directly
related to and necessary for the proper application of the rules applicable
for PACs
• you acknowledge and agree that you are fully liable for any charges
incurred if the debits cannot be made due to insufficient funds or any
other reason for which you may be held accountable
• you confirm that all persons whose signatures are required to authorize
transactions in the bank account provided have read and agreed to these
terms and signed this application
Withdrawals and Automatic Withdrawals (AWDs)
• Income Class withdrawals in excess of the annual LWA may have a
negative impact on future LWA payments
Instructions on completing section 9:
• Payment Type:
- select one payment type for this Contract
- a sub-option may then be required depending on the payment type
elected
• Payment Fund Breakdown:
- in this section specify the fund breakdown of your payments. There is a
column for each Class. The total per Class should equal 100% of the
payment that will be made from the funds of that Class
• Payment Frequency, Start Date and Method:
- complete by specifying the Payment Frequency, Start Date and Method
CI Investments Privacy Statement for Canada
Upon receipt of this application, CI will establish a file in which will be placed
personal information about you concerning this application, endorsement,
rider or other documents issued in connection with this application, and other
documents or information relating to the investigation, servicing and
administration of this application. We collect personal information about you
from this application and any supplementary forms, and from your
representative and other organizations and persons you identify in support of
your application. We use your personal information for the purposes of,
servicing and administering this application, and for such other purposes as
are specified in this application. Your information may be shared with your
representative of record for the purposes identified above. Your Social
Insurance Number will be used for income reporting purposes in the context
of the administration of your account. Your banking information will be
disclosed to the financial institution(s) processing your pre-authorized deposit
plan. Employees or authorized representatives of CI or its affiliates, who will
be responsible for functions relevant to the purposes identified above, and
other persons authorized by you or by law, will have access to the personal
information contained in your file. Note that your financial advisor or broker is
not an employee of CI. Subject to exceptions set out in applicable legislation,
you may access your file and request corrections to your personal information
by sending a written request to CI Investments Inc, Attn: Privacy Officer,
15 York Street, Second Floor, Toronto, Ontario M5J 0A3. By completing and
signing this application, you consent to the collection, use and
disclosure of your personal information as described herein. CI’s
Privacy Policy is available on the CI Website, www.ci.com.
Sun Life Financial Privacy Statement for Canada
At Sun Life Financial, protecting your privacy is a priority. We maintain a
confidential file in our offices containing personal information about you and
your contract(s) with us. Our files are kept for the purpose of providing you
with investment and insurance products or services that will help you meet
your lifetime financial objectives. Access to your personal information is
restricted to those employees, representatives, distribution partners (such as
advisors and their companies) and third party service providers who are
responsible for the administration, processing and servicing of your contract(s)
with us, our reinsurers or any other person whom you authorize. In some
instances these persons may be located outside Canada, and your personal
information may be subject to the laws of those foreign jurisdictions. You are
entitled to consult the information contained in our file and, if applicable, to
have it corrected by sending a written request to us. Our Privacy Policy informs
you that we will tell you about other products and services we offer and on
how you can tell us if you no longer want this information. To find out about
our Privacy Policy, visit our website at www.sunlife.ca, or to obtain
information about our privacy practices, send a written request by
e-mail to privacyofficer@sunlife.com, or by mail to Privacy Officer,
Sun Life Financial, 225 King St. West, Toronto, ON M5V 3C5.
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SunWise ® Essential Series
Individual Variable Annuity Contract
Tax-Free Savings Account (TFSA) Application Form
1 Contract Number (if available)
SunWise Essential Series Contract Number _________________ ______ Distributor’s Account Number ________________________
2 Distributor and Representative
Information
Distributor's Name
Representative's Name
M A N D-
A T O R Y
Distributor Number Representative Number Telephone Number E-mail Address
Training Supervisor's signature (Quebec Only) X
3 Planholder Information
The Planholder is required to be the
Annuitant
❍ Mr. ❍ Mrs. ❍ Miss ❍ Ms. ❍ Dr. Gender ❍ Male ❍ Female
M A N D A T O R Y
Planholder's Name (last, first, middle)
M A N D A T O R Y
Planholder's Address City or Town Province
M A N D A T O R Y
Postal Code Country of Residency Residence Telephone Number
Y Y Y Y / M M / D D
M A N D A T O R Y
M A N D A T O R Y
Date of Birth Social Insurance Number (SIN) Planholder’s E-mail Address
4 Beneficiary Designation
For Contracts signed in Quebec
the designation of a spouse
(married or civil union) as beneficiary
is irrevocable unless the Planholder
checks revocable here: ❍ revocable
For the Two-Life Income Stream
option you must name your spouse
as sole primary beneficiary.
Primary Beneficiary Relationship to Share Contingent Beneficiary Relationship to
Name(s) Annuitant (%) Name(s) (for the adjacent share) Annuitant
Total 100%
Name of Trustee(s) appointed for minor beneficiary(ies) (appointed administrator in Quebec) _______________________________________
❍ I have attached a letter of direction with additional/alternate/irrevocable beneficiary instructions.
5 LWA Income Streams for the
Income Class (MANDATORY)
LWA payments cannot begin if a
LWA Income Stream has
not been selected.
* Spouse has the meaning as defined
by the Income Tax Act
LWA Income Stream: An LWA Income Stream must be elected at the time of the first deposit into the Income Class and may not be
changed.
❍ One-Life Income Stream
❍ Two-Life Income Stream (for Two-Life Income Stream the Second Life must be the Annuitant’s spouse* Spousal details must be
provided below)
Please complete the Spousal information below when electing the Two-Life Income Stream.
Gender ❍ Male ❍ Female
M A N D A T O R Y
Name (last, first, middle)
Y Y Y Y / M M / D D
M A N D A T O R Y M A N D A T O R Y M A N D A T O R Y
Date of Birth Social Insurance Number (SIN) Country of Residency
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6 LWA Protection Service
CI will add the LWA Protection Service to ensure that withdrawals in your Income Class do not exceed your LWA.
To remove this service please check here ❍
7a Investment Directions
The fund code will determine the
guarantee Class and sales charge
option of the units.
Class Contract Death
Guarantee Guarantee
Income 75% 100%
Estate 75% 100%
Investment 75% 75%
Please specify your PAC details
in Section 8.
❍ Cheque in the amount of $ ______________________________________________________________________________
A M O U N T
❍ Transfer $ __________________ A M O U N T
from another financial institution ____________________________(T2033/T2151/TD2 ( I N S T I T U T I O N N A M E )
attached)
❍ Transfer $ __________________ A M O U N T from an existing CI account __________________________________________________
( C I A C C O U N T N U M B E R )
Fund Code Initial Sales Gross Amount PAC Amount Fund Code Initial Sales Gross Amount PAC Amount
Charge $ or % $ or % Charge $ or % $ or %
(if applicable)
(if applicable)
%
%
By making deposits into the Estate
Class or Income Class you acknowledge
having read the applicable sections of
the Information Folder and Individual
Variable Annuity Contract and agree to
the applicable fees.
%
%
%
%
%
%
%
%
7b Instruction for a Partial
Transfer from an Existing
CI Account
For Partial Transfers from an existing CI account please specify the details below:
❍ Transfer in amount ____________________________________________
A M O U N T
From CI Account Number Fund Code Amount to transfer from an existing CI Account
$ or %
Will this transfer be reoccurring annually ❍ Yes
❍ No (If yes please specify the date that you wish the automatic transfer to occur)
Reoccurring Transfer Start Date _____________________________________
Y Y Y Y / M M / D D
8 Pre-Authorized Chequing Plan
Please complete Section 10 and
specify the fund breakdown in the
PAC amount column in Section 7a.
❍ I choose to receive plan payment
confirmations. (All Planholders
receive annual statements
detailing transactions in their
Contract.)
PAC Amount
PAC amount $ ____________________________ (Please ensure you meet the minimum required amount.)
Payment Frequency (please select only one)
❍ Weekly ❍ Bi-weekly ❍ Monthly ❍ Bi-monthly
❍ Quarterly ❍ Semi-Annually ❍ Annually
Signature(s)
Date:
Payment Start Date
Y Y Y Y / M M / D D
Y Y Y Y / M M / D D
Signature(s) required if Depositor(s) is (are) other than the Planholders(s) indicated in Section 3. For a joint bank account, all Depositors
must sign if more than one signature is required on cheques issued against the account.
By signing you confirm the banking information provided in Section 10 and that you have read and agree to the PAC terms and conditions
outlined at the front of this Application.
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9 Automatic Withdrawal Plan
(AWD)
Please review the AWD description
in the front of this Application for
assistance in completing this section.
Income Class withdrawals in excess of
the annual LWA may have a negative
impact on future LWA payments.
Payments above the LWA that will
result in an Excess Withdrawal will not
be processed if the LWA Protection
Service is on.
Please see Section 6.
*If your Payment Start Date is prior to
January 1 of the year the Annuitant (or,
if a Second Life is designated, the
younger of the Annuitant and the
Second Life) turns 65 years of age and
you would like to make the Age 55
LWA Election please complete the
SunWise Essential Series Withdrawal
Order Ticket and submit along with this
Application Form.
If you have any questions about this
section please contact CI Client
Services 1-800-563-5181
Step 1 - Payment Type:
Select one option, then complete the Payment Fund Breakdown and Payment Frequency, Start Date and Method sections below.
a. ❍ Lifetime Withdrawal Amount (LWA) - withdraw only from my Income Class
b. ❍ An annual amount of $_________ ❍ Gross ❍ Net of fees
Estate Investment
Select one option below and specify percent allocation:
Class (%) Class (%)
Total
❍ LWA and remainder as follows: g
100%
❍ I am not taking LWA payments. Withdraw only from my Estate
and/or my Investment Class as follows: g
100%
Step 2 - Payment Fund Breakdown: For each Class you indicated above, provide your fund breakdown. Use percentages only and
ensure each Class you elect has a payment that totals 100%.
Complete if you indicated in Step 1 that you
are taking payments from Income Class (LWA).
Payment Frequency (please select only one)
❍ Monthly ❍ Quarterly ❍ Semi-Annually ❍ Annually
Payment Method
❍ Deposit directly to bank account (please complete Section 10)
❍ Mail to Planholder’s address on file
❍ Mail to Planholder’s alternate address (indicate address below)
Complete if you selected option b in Step 1. Be sure you have filled out the Class
percent (%) allocation in Step 1 for the payment option chosen.
Income Class (LWA) Fund Breakdown Estate Class Fund Breakdown Investment Class Fund Breakdown
Fund Code % Fund Code % Fund Code %
Total 100% Total 100% Total 100%
Step 3 - Payment Frequency, Start Date and Method:
Payment Start Date*
Y Y Y Y / M M / D D
Address City Province Postal Code
10 Banking Information
Please complete for section 8 and/or 9
and attach a void cheque
Bank Account Owner(s) Name(s)
Bank Name
Bank Number Bank Transit Number Bank Account Number
11 Group TFSA
I certify that I am an employee of the company or association named in this section and hereby authorize such employer or association to
deduct from my earnings and remit contributions to the CI Investments Group Plan (as indicated in Section 7a) and to assist in the
administration of the Plan as my agent.
I understand that only the issuer has the authority to amend the arrangement and the ultimate responsibility for administering the
arrangement lies with the issuer.
Group Company Name ____________________________________________________________________________________
Employee's Signature _____________________________________________________________________________________
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12 Planholder Acknowledgement/
Authorization
The Planholder and Second Life
(if applicable) must read and
sign this Section
I declare that all statements and answers made by me on this Application are fully complete and true.
I hereby acknowledge having read the provisions contained in the ”Sun Life Privacy Statement for Canada“ and ”CI Investment Privacy
Statement for Canada“, contained in this Application, and I hereby agree to them and hereby authorize Sun Life Assurance Company of
Canada and CI Investments to obtain, use, and transmit to its agents and service providers, personal information about me for the purpose
of the administration of this Contract.
I have requested that all documents be delivered to me in connection with this Contract be written in English. Je demande que tous les
documents qui vous sont remis avec ce contrat soient rédigés en langue anglaise.
I acknowledge receipt of the Individual Variable Annuity Contract and Information Folder and the Fund Facts prior to signing the Application.
By completing the PAC section, I declare that all persons whose signatures are required to authorize transactions in the bank account
provided have read and agreed to the PAC terms and conditions as outlined at the front of this Application.
By signing this Application I request Sun Life Assurance Company of Canada to file an election with the Minister of National Revenue to
register the qualifying arrangement as a TFSA under section 146.2 of the Income Tax Act.
X M A N D A T O R Y
Planholders's Signature
Date
Y Y Y Y / M M / D D
Please ensure all mandatory
sections have been completed.
Second Life's Signature (must be the spouse of the Annuitant) X ______________________________________________________
M A N D A T O R Y
Y Y Y Y / M M / D D
Date
Signed At (City and Province) ___________________________________________________________________________________________
M A N D A T O R Y
Signature(s) required if transferring from a Joint Ownership Account where more than one signature is required in order to process a
transaction on the account.
X
Joint Owner(s) Signature
Y Y Y Y / M M / D D
Date
13 Representative's
Acknowledgement
All advisors must read and
sign this Section
I, the advisor, confirm that I have reviewed the details provided in this form with the Applicant/Policyholder and to the best of my
knowledge, unless otherwise noted, these details are full, complete and true. I confirm that I have disclosed to the Planholder (a) the
companies I represent, (b) that I will receive compensation in the form of commissions or salary for the sale of this product, (c) that I may
also receive additional compensation in the form of bonuses or non-monetary benefits such as travel incentives or attendance at
conferences, and (d) any conflict of interest I may have with respect to the sale of this product.
X Y Y Y Y / M M / D D
M A N D A T O R Y
Representative's Signature Date
ANY AMOUNT THAT IS ALLOCATED TO A SEGREGATED FUND IS INVESTED AT THE RISK
OF THE CONTRACT HOLDER AND MAY INCREASE OR DECREASE IN VALUE.
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Sun Life Assurance Company of Canada, a member of the Sun Life Financial group of companies, is the sole issuer of the individual variable annuity
contract providing for investment in SunWise Essential Series segregated funds. A description of the key features of the applicable individual variable
annuity contract is contained in the Information Folder. Any amount that is allocated to a segregated fund is invested at the risk of the contract
holder and may increase or decrease in value. ® CI Investments and the CI Investments design are registered trademarks of CI Investments Inc.
®
SunWise is a registered trademark of Sun Life Assurance Company of Canada.
Sun Life Assurance Company of Canada
227 King Street South
P.O. Box 1601 STN Waterloo
Waterloo, Ontario N2J 4C5
CI Investments, 15 York Street, Second Floor, Toronto, Ontario M5J 0A3 I
Head Office / Toronto
416-364-1145
1-800-268-9374
Calgary
403-205-4396
1-800-776-9027
Montreal
514-875-0090
1-800-268-1602
www.ci.com
Vancouver
604-681-3346
1-800-665-6994
Client Services
English: 1-800-563-5181
French: 1-800-668-3528
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